Prevalence of COPD in Spain: impact of undiagnosed COPD on quality of life and daily life activities
- M Miravitlles1,
- J B Soriano2,
- F García-Río3,
- L Muñoz4,
- E Duran-Tauleria5,
- G Sanchez6,
- V Sobradillo7,
- J Ancochea8
- 1Fundació Clínic, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
- 2Fundación Caubet-CIMERA. Bunyola, Illes Balears, Spain
- 3Pneumology Department, Hospital La Paz, Madrid, Spain
- 4Pneumology Department, Hospital Reina Sofía, Córdoba, Spain
- 5IMIM/CREAL, Barcelona, Spain
- 6Medical Department, GlaxoSmithkline, Madrid, Spain
- 7Pneumology Department, Hospital de Cruces, Bilbao, Spain
- 8Pneumology Department, Hospital La Princesa, Madrid, Spain (CIBER de Enfermedades Respiratorias (CIBERES))
- Correspondence to Dr M Miravitlles, Servei de Pneumologia, Hospital Clínic, Villarroel 170, 08036 Barcelona, Spain;
- Received 23 February 2009
- Accepted 10 June 2009
- Published Online First 23 June 2009
Aims: This study aimed to determine the prevalence of chronic obstructive pulmonary disease (COPD) in Spain and identify the level of undiagnosed disease and its impact on health-related quality of life (HRQL) and activities of daily living (ADL).
Methods: A population-based sample of 4274 adults aged 40–80 years was surveyed. They were invited to answer a questionnaire and undergo prebrochodilator and postbronchodilator spirometry. COPD was defined as a postbronchodilator FEV1/FVC (forced expiratory volume in 1 s/forced vital capacity) ratio of <0.70.
Results: For 3802 participants with good-quality postbronchodilator spirometry, the overall prevalence of COPD was 10.2% (95% CI 9.2% to 11.1%) and was higher in men (15.1%) than in women (5.6%). The prevalence of COPD stage II or higher was 4.4% (95%CI; 3.8%–5.1%). The prevalence of COPD increased with age and with cigarette smoking and was higher in those with a low educational level. A previous diagnosis of COPD was reported by only 27% of those with COPD. Diagnosed patients had more severe disease, higher cumulative tobacco consumption and more severely impaired HRQL compared with undiagnosed subjects. However, even patients with undiagnosed COPD stage I+ already showed impairment in HRQL and in some aspects of ADL compared with participants without COPD.
Conclusions: The prevalence of COPD in individuals between 40 and 80 years of age in Spain is 10.2% and increases with age, tobacco consumption and lower educational levels. The rate of diagnosised COPD is very high and undiagnosed individuals with COPD already have a significant impairment in HRQL and ADL.
Funding The EPI-SCAN study has been funded by an unrestricted grant from GlaxoSmithKline Spain.
Competing interests GS is a full-time employee of GlaxoSmithKline, drug manufacturer and sponsor of the study. However, the subject of the study is epidemiological with no drugs involved. The rest of authors do not have any conflict of interest with relation to the contents of the manuscript.
Provenance and Peer review Not commissioned; externally peer reviewed.
Ethics approval The study was approved by the Ethics Committee of the Hospital Clinic de Barcelona, as a reference IRB and consequently by the local Ethics Committees of the participating centres.
▸ Additional information about the population of the study is published online only at http://thorax.bmj.com/content/vol64/issue10